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Burns/second degree healing process

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Expert: Jim B - 10/31/2008


Question
QUESTION: Hello,

My 2 year old son suffered a second degree burns from knee to top of foot. almost one week after burn he formed a white layer that seemed pretty thick which I have learned that is called Eschar. now most of white is gone (almost 95% gone) skin look strong pink with little white. I just want to make sure that we are doing ok. we have been using Flamazine(Silver sulphadiazine) but on other parts of leg where he suffered less burns we used an herbal ointment called MEBO (composed of B-sitostero 0.25%, also sesame seeds and beeswax)and other amino, fatty acids. Mebo showed a very good progress. When can I switch to it to treat rest of leg. Are we doing OK?

ANSWER: Hi Luai,

The place where eschar developed is likey to have been a third degree injury which may well develop as a scar. This may require grafts to heal properly. I am not familiar with the MEBO or the use of seseme seeds as a treatment, but it seems to be working at this point. The key thing at this point of any burn treatment is to avoid infection and protect the wounds from further injury during healing. All of this seems to be happenig so far. I would be seeking the advice and treatment of a burn trained doctor or (Best) a burn center.

Jim

---------- FOLLOW-UP ----------

QUESTION: Thank you Jim,

Is it possible that skin would grow on third degree burns without need for grafts.

Luai

Answer
Hi Luai,

It is possible that scars can be reduced and some normal skin will develop from hair follicles and sweat ducts, but this is dependant on hoe deep the burn is. Some marginal third degree burns leave enough dermis for this to happen, but it requires a skilled burn doctor to really see the burn. Also some doner grafts will (on occasion, protect enough cells for the scars to be reduced in a significant manner, but as a general rule a third degree burn will produce a scar. The exceptions are completely dependant on the depth of the burn.

In most cases where there is any doubt whether a wound will heal to close to normal we would graft the burn area, especially over joints and feet.

Jim

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Jim B

Expertise

I can answer a variety of questions concerning the physical care of burns and burn patients which commonly are of interest to both patients and their families. Also I may be helpful in suggesting lifestyle modifications which will help with a more complete recovery from a serious burn. I can also accept questions regarding the physical classifications of burns and the implications regarding the size, depth, and location of burns. What I cannot answer based on my own knowledge and experience I can refer to my current and former collegues in the field including the plastic and trauma surgeons and burn recovery organizations. In many of these cases I will provide a line of communication directly to a specific expert or organization. While I can describe general treatments routines with which I am experienced,I cannot answer questions dealing with specifuc diagnosis of conditions or problems. Additionally, please understand that the area of burn treatments is an experimental one in which there is constant progress and change. Each Burn Center invests a major effort in the development of new materials, treatments, medications, and techniques. In this area of constant change and growth no one can be fully aware of all treatment courses employed.

Experience

I am a licensed Paramedic and have also worked as a wound technician in a large regional Burn Center in a Trauma Level 1 hospital. I have experience in the areas of burn evaluation and care, both long-term and immediate first aid. I have also worked as a volunteer couselor with post-burn patients dealing with issues ranging from life-style changes to re-entering the world as a serious burn survivor.

Education/Credentials
BA Economics and Biology, AA Health Care Management, EMT-P licensed in Missouri, ABLS (Advanced Burn Life Support)qulification, ACLS-EP (Advanced Cardiac Life Support-Experienced Provider), Former National Ski Patrol Winter Emergency Care Instructor and Senior Evaluator, Emergency Medical Technician and Paramedic Instructor.

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